Bridging University Institutional and Accreditation Standards: An Advanced Practice Registered Nurse (APRN) Program Exemplar

The complexity of the health care environment requires the nursing profession to effectively anticipate current and future health care needs. Similarly, nursing education must ensure preparedness of future nursing professionals as well as meet the rigor of program accreditation standards. South Dakota State University (SDSU) College of Nursing Master’s and Doctor of Nursing Practice (DNP) programs are accredited by the Commission on Collegiate Nursing Education (CCNE), one of the two national specialized accrediting bodies for nursing. Both graduate programs must align with an American Association of Colleges of Nursing (AACN) Essentials document that corresponds to the respective degree and specialty, e.g. family nurse practitioner (FNP). Required curricular framework, components, and competencies are mapped within The Essentials of Master’s Education in Nursing and The Essentials of Doctoral Education for Advanced Nursing Practice. Both documents inform curricular content needed to meet core competencies specific to all Advanced Practice Registered Nursing (APRN) roles, such as the family nurse practitioner (AACN, 2006)

10-year follow-up of patients with rheumatoid arthritis and secondary Sjogren's syndrome or sicca symptoms in daily clinical practice

Objective. To evaluate the presence of sicca symptoms and secondary Sjogren's syndrome (SS) and the association with clinical characteristics, functional tests and patient-reported outcomes in patients with rheumatoid arthritis (RA) at baseline and after 10 years of follow-up. Methods. A cohort of RA patients was evaluated in 2008 and re-evaluated in 2018 with respect to sicca symptoms, presence of secondary SS according to AECG classification criteria, disease activity of RA and patient-reported outcomes. Patient characteristics were compared between the RA-non-sicca, RA-sicca and RA-SS groups. Results. Of the original 2008 cohort of 96 RA patients, 32 (33%) had sicca symptoms and 6 (6.3%) secondary SS. Of the 36 patients who agreed to be reevaluated in 2018, 6 (17%) had sicca symptoms and 2 (6%) developed secondary SS. In the majority of patients, sicca symptoms were reversible while the functional tests of salivary and lacrimal glands significantly decreased. 67% of RA-sicca patients had no sicca complaints at the second screening, while only two RA-sicca patients developed secondary SS. RA-SS patients and, to a slightly lesser extent, RA-sicca patients had significantly higher RA disease activity (DAS-28), lower lacrimal (Schirmer's test) and salivary gland function, more limitations in daily activities (HAQ), worse health-related quality of life (RAND-36), more fatigue (MFI) and more patient symptoms (ESSPRI) compared to RA-non-sicca patients. Conclusion. Secondary SS was found in a minor subset of the RA patients. Sicca symptoms of the eyes or mouth were more frequent, but their presence varied over time. Higher RA disease activity was associated with SS and sicca symptoms. These patients had lower gland function and worse patient-reported outcomes

10-year follow-up of patients with rheumatoid arthritis and secondary Sjogren's syndrome or sicca symptoms in daily clinical practice

Objective. To evaluate the presence of sicca symptoms and secondary Sjogren's syndrome (SS) and the association with clinical characteristics, functional tests and patient-reported outcomes in patients with rheumatoid arthritis (RA) at baseline and after 10 years of follow-up. Methods. A cohort of RA patients was evaluated in 2008 and re-evaluated in 2018 with respect to sicca symptoms, presence of secondary SS according to AECG classification criteria, disease activity of RA and patient-reported outcomes. Patient characteristics were compared between the RA-non-sicca, RA-sicca and RA-SS groups. Results. Of the original 2008 cohort of 96 RA patients, 32 (33%) had sicca symptoms and 6 (6.3%) secondary SS. Of the 36 patients who agreed to be reevaluated in 2018, 6 (17%) had sicca symptoms and 2 (6%) developed secondary SS. In the majority of patients, sicca symptoms were reversible while the functional tests of salivary and lacrimal glands significantly decreased. 67% of RA-sicca patients had no sicca complaints at the second screening, while only two RA-sicca patients developed secondary SS. RA-SS patients and, to a slightly lesser extent, RA-sicca patients had significantly higher RA disease activity (DAS-28), lower lacrimal (Schirmer's test) and salivary gland function, more limitations in daily activities (HAQ), worse health-related quality of life (RAND-36), more fatigue (MFI) and more patient symptoms (ESSPRI) compared to RA-non-sicca patients. Conclusion. Secondary SS was found in a minor subset of the RA patients. Sicca symptoms of the eyes or mouth were more frequent, but their presence varied over time. Higher RA disease activity was associated with SS and sicca symptoms. These patients had lower gland function and worse patient-reported outcomes

Nucleosomes in pancreatic cancer patients during radiochemotherapy

Nucleosomes appear spontaneously in elevated concentrations in the serum of patients with malignant diseases as well as during chemo- and radiotherapy. We analyzed whether their kinetics show typical characteristics during radiochemotherapy and enable an early estimation of therapy efficacy. We used the Cell Death Detection Elisaplus ( Roche Diagnostics) and investigated the course of nucleosomes in the serum of 32 patients with a local stage of pancreatic cancer who were treated with radiochemotherapy for several weeks. Ten of them received postsurgical therapy, 21 received primary therapy and 1 received therapy for local relapse. Blood was taken before the beginning of therapy, daily during the first week, once weekly during the following weeks and at the end of radiochemotherapy. The response to therapy was defined according to the kinetics of CA 19-9: a decrease of CA 19-9 650% after radiochemotherapy was considered as `remission'; an increase of >= 100% ( which was confirmed by two following values) was defined as `progression'. Patients with `stable disease' ranged intermediately. Most of the examined patients showed a decrease of the concentration of nucleosomes within 6 h after the first dose of radiation. Afterwards, nucleosome levels increased rapidly, reaching their maximum during the following days. Patients receiving postsurgery, primary or relapse therapies did not show significant differences in nucleosome values during the time of treatment. Single nucleosome values, measured at 6, 24 and 48 h after the application of therapy, could not discriminate significantly between patients with no progression and those with progression of disease. However, the area under the curve of the first 3 days, which integrated all variables of the initial therapeutic phase, showed a significant correlation with the progression-free interval ( p = 0.008). Our results indicate that the area under the curve of nucleosomes during the initial phase of radiochemotherapy could be valuable for the early prediction of the progression-free interval. Copyright (C) 2005 S. Karger AG, Basel